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Wang YF, Hsu YF, Fang KT, Kuo LT. Gamification in medical education: identifying and prioritizing key elements through Delphi method. MEDICAL EDUCATION ONLINE 2024; 29:2302231. [PMID: 38194415 PMCID: PMC10778414 DOI: 10.1080/10872981.2024.2302231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Gamification has gained popularity in medical education, but key elements have not been formally identified. This study aimed to generate and prioritize a list of key elements of gamification in medical education. METHODS This study utilized a two-stage approach, including the Delphi method and qualitative interview. Nineteen medical educators with expertise in gamification participated in the Delphi method stage. Experts who had more than three years of experience with gamification in medical education constituted the expert panel. The experts were then asked to rate the gamification elements using the Likert five-point scale through at least two consensus-seeking rounds. Consensus for key elements was predefined as ≥ 51% of respondents rating an element as 'important' or"very important." In the qualitative interview stage, 10 experts provided feedback on the application of these key gamification elements. RESULTS Eighteen participants (11 males and 7 females) completed the entire Delphi process for this study. After two rounds of surveys, the consensus was reached on all elements. Thirteen elements scored more than 4 points (37%) and reached the criteria of key elements of gamification in medical education. The top five key elements were integration with instruction objectives, game rules, rapid feedback, fairness, and points/scoring. The thirteen key elements for successful gamification in medical education were further organized into two main categories: (1) gamification design principles and (2) game mechanisms. CONCLUSIONS Integration with educational objectives, gamification in curriculum design and teaching methods, and balancing between the mechanisms and principles were the three key components for successful gamification. This study explored the gamification key elements, providing practical tips for medical educators in their efforts to gamify medical education. Future studies involving learners could be performed to examine the efficacy of these key elements in gamification.
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Affiliation(s)
- Yung-Fu Wang
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Ya-Fang Hsu
- Department of Long-term Care and Health Promotion, Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Kwo-Ting Fang
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Liang-Tseng Kuo
- Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Puri A, Yang SC, Kozower BD. Gamification in cardiothoracic surgical education: Time to learn more. J Thorac Cardiovasc Surg 2024; 168:175-181. [PMID: 38521494 DOI: 10.1016/j.jtcvs.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Arjun Puri
- Mary Institute and Saint Louis Country Day School, St Louis, Mo
| | - Stephen C Yang
- Division of Thoracic Surgery, Johns Hopkins Medical Institutions, Baltimore, Md
| | - Benjamin D Kozower
- Division of Cardiothoracic Surgery, Washington University School of Medicine in St Louis, St Louis, Mo.
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Vipler B, Merritt F, Arnold-Rehring S, Zimmer S, Adams J, Faubel S. Inquiry for the win: Fostering curiosity through a BINGO exercise in a longitudinally integrated clerkship. MEDICAL TEACHER 2024:1-4. [PMID: 38889323 DOI: 10.1080/0142159x.2024.2362905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
EDUCATIONAL CHALLENGE As technological advancements challenge the current roles healthcare workers fill, curiosity and lifelong learning are becoming increasingly important. However, descriptions of specific curricular interventions that successfully develop these attitudes and skills remain limited. PROPOSED SOLUTION We aimed to promote curiosity and advance practical application of evidenced-based medicine through a longitudinal, gamified learning activity within a longitudinal integrated clerkship (LIC). Thirty-seven students across two inquiry-themed LICs based at a university hospital and a community-based integrated healthcare delivery system used BINGO cards containing various assignments designed to develop the skill of asking and answering clinical questions. Assignments included: engaging experts, using evidence-based medical resources, attending education events, utilizing medical library resources, and Phone-a-Scientist. Students shared their experiences in a group setting and wrote a reflection for each assignment that was qualitatively analyzed to determine the perceived educational outcomes according to the Kirkpatrick Evaluation Model. LESSONS LEARNED Results suggest that Inquiry BINGO fosters curiosity and builds skill in applied evidenced-based medicine early in clinical training. Most assignments prompted students to engage in opportunities they might not have otherwise explored. All but three students reported a change in behavior as a result of the assignment and 57% reported positive clinical or research results. NEXT STEPS Future iterations of this activity should be evaluated by obtaining patient and/or preceptor feedback as well as longitudinal evaluations of student behavior to ensure higher level educational outcomes are being met.
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Affiliation(s)
- Benjamin Vipler
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, University of Colorado Hospital, CO, USA
| | - Frank Merritt
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, University of Colorado Hospital, CO, USA
| | - Sharisse Arnold-Rehring
- Department of Pediatrics, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, Kaiser Permanente, CO, USA
| | - Shanta Zimmer
- Department of Medicine, University of Colorado School of Medicine, Senior Associate Dean of Education, CO, USA
| | - Jennifer Adams
- Department of Medicine, University of Colorado School of Medicine, Assistant Dean of Medical Education, Clinical Clerkships, CO, USA
| | - Sarah Faubel
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Content, University of Colorado Hospital, CO, USA
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Meco BC, Guclu CY, Berger-Estilita J, Radtke FM. The way towards ethical anesthesia care: no aim - no game - no fame or blame? Curr Opin Anaesthesiol 2024:00001503-990000000-00201. [PMID: 38841922 DOI: 10.1097/aco.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW This review explores the intricacies of ethical anesthesia, exploring the necessity for precision anesthesia and its impact on patient-reported outcomes. The primary objective is to advocate for a defined aim, promoting the implementation of rules and feedback systems. The ultimate goal is to enhance precision anesthesia care, ensuring patient safety through the implementation of a teamwork and the integration of feedback mechanisms. RECENT FINDINGS Recent strategies in the field of anesthesia have evolved from intraoperative monitorization to a wider perioperative patient-centered precision care. Nonetheless, implementing this approach encounters significant obstacles. The article explores the evidence supporting the need for a defined aim and applicable rules for precision anesthesia's effectiveness. The implementation of the safety culture is underlined. The review delves into the teamwork description with structured feedback systems. SUMMARY Anesthesia is a multifaceted discipline that involves various stakeholders. The primary focus is delivering personalized precision care. This review underscores the importance of establishing clear aims, defined rules, and fostering effective and well tolerated teamwork with accurate feedback for improving patient-reported outcomes. The Safe Brain Initiative approach, emphasizing algorithmic monitoring and systematic follow-up, is crucial in implementing a fundamental and standardized reporting approach within patient-centered anesthesia care practice.
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Affiliation(s)
- Basak Ceyda Meco
- Departement of Anaesthesia and Intensive Care, Ankara University Faculty of Medicine
- Ankara University Brain Research Center (BAUM), Ankara, Turkey
| | - Cigdem Yildirim Guclu
- Departement of Anaesthesia and Intensive Care, Ankara University Faculty of Medicine
| | - Joana Berger-Estilita
- Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group
- Institute for Medical Education, University of Bern, Bern, Switzerland
- CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, Porto, Portugal
| | - Finn M Radtke
- Department of Anaesthesia and Intensive Care, Sjaellands University Hospital Nykøbing Falster, & University of Southern Denmark, Odense, Denmark
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Wettergreen SA, Scott C, Auten M, Kiles TM, Litten K, Scott D, Stewart MP. A meta-narrative review of choose-your-own-adventure style patient case activities in pharmacy education. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:484-495. [PMID: 38538451 DOI: 10.1016/j.cptl.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/05/2024] [Accepted: 03/16/2024] [Indexed: 05/15/2024]
Abstract
BACKGROUND The objective of this review was to characterize the methods of delivery and assessment of Choose Your Own Adventure (CYOA)-style activities in pharmacy education. A secondary objective was to utilize available data to determine best practices for educators interested in developing similar activities. METHODS A meta-narrative approach according to the guidance of the RAMESES standards was used for this review. A broad literature search was conducted using PubMed and Embase. Studies published on the use of a CYOA-style patient case format in pharmacy education were identified and appraised individually for their relevance. RESULTS Thirteen studies from the pharmacy education literature were included in the review. Activities were delivered for 25 unique topics, largely in small groups during class via patient simulation or interactive data collection software. Overall, students have a positive perception of CYOA-style activities, with positive results regarding knowledge development and student engagement. The most commonly reported challenge to implementing CYOA-style patient case activities was the up-front time commitment to develop activities. IMPLICATIONS This review provides a snapshot of the small but expanding body of literature on CYOA-style patient case activities in pharmacy education. CYOA-style activities are recommended for expanded use in pharmacy education as the preponderance of studies that assessed knowledge development showed significant improvement in knowledge after participation in CYOA-style activities. Additionally, students have a positive perception of CYOA-style activities and reported that they were enjoyable, improved their confidence, and helped them learn course material.
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Affiliation(s)
- Sara A Wettergreen
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd., C238, Aurora, Colorado 80045, United States of America.
| | - Collyn Scott
- PGY-1 Pharmacy Practice Resident, UCHealth Memorial Hospital, 1400 E. Boulder St., Colorado Springs, Colorado 80909, United States of America.
| | - Madison Auten
- Ambulatory Care Clinical Pharmacist, Saint Luke's Health System, 20 NE Saint Luke's Blvd Suite 200, Lee's Summit, MO 64086, United States of America.
| | - Tyler Marie Kiles
- Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center College of Pharmacy, 881 Madison Avenue, Room 581, Memphis, TN 38193, United States of America.
| | - Kathryn Litten
- Division of Pharmacy Practice, The University of Texas at Austin College of Pharmacy, 2409 University Ave., Austin, TX 78712, United States of America.
| | - Devin Scott
- Teaching and Learning Center, The University of Tennessee Health Science Center, 920 Madison Avenue, Suite 424, Memphis, TN 38193, United States of America.
| | - Morgan P Stewart
- Division of Pharmacy Practice, The University of Texas at Austin College of Pharmacy, 2409 University Ave., Austin, TX 78712, United States of America.
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Afonso MVR, Lopes RB, Andrade EF, Pereira LJ. Game-based learning enhances students' understanding of endocrine physiology in veterinary medicine. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:155-163. [PMID: 38234294 DOI: 10.1152/advan.00182.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/19/2024]
Abstract
Endocrine physiology is a complex subject for students. Game-based learning (GBL) and case-based learning (CBL) are active methodologies that are widely used because of their potential for motivation and greater proximity to the reality of modern students. We evaluated the effectiveness of GBL and CBL among veterinary medicine students compared with a control group using peer tutoring. Students (n = 106) from two institutions volunteered to participate in this study. The participants were submitted to a pretest questionnaire and subsequently were divided into three paired groups by their performance on the pretest exam: 1) traditional class + peer tutoring, 2) traditional class + GBL, and 3) traditional class + CBL. After the students completed the activities, their performance was once again evaluated by applying a new test with the same initial 10 questions and another set of 10 different questions. The students' perceptions and satisfaction with the methodologies and learning strategies were assessed. Anxiety was assessed with the State-Trait Anxiety Inventory before and after the conventional class and after the active methodologies. The GBL group significantly improved their correct answers compared with the baseline (P < 0.05), with no significant difference from CBL and peer tutoring. Anxiety levels did not differ regardless of the time of evaluation or the teaching methodology applied. GBL promoted a greater perception of the stimulus for self-study and problem-solving ability and contributed to the development of group dynamics compared with the group who received CBL (P < 0.05). In conclusion, GBL showed better results than peer tutoring and CBL.NEW & NOTEWORTHY We compared the supplementary use of game-based learning, case-based learning, and peer tutoring in the study of endocrine physiology by veterinary students and observed a slight advantage for game-based learning over the other two methodologies. The game was developed by the authors and is an unprecedented tool that can prove useful to improve knowledge acquisition in students of veterinary medicine. Thus, game-based learning is an effective supplementary teaching strategy.
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Affiliation(s)
| | - Rodrigo Braga Lopes
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Eric Francelino Andrade
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Luciano José Pereira
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
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Yıldız M, Yildiz M, Kayacık AD. Rising gamification in health education: A bibliometric study. Nurse Educ Pract 2024; 78:103993. [PMID: 38788617 DOI: 10.1016/j.nepr.2024.103993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/28/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The rising gamification in educational contexts has been driven by its potential to increase student motivation, engagement, interest and learning outcomes. Thanks to these effects, gamification has gained popularity in health education. Due to the increase in studies on gamification in health education in recent years, this study has been carried out to present the studies in the relevant literature to researchers. AIM This study presents a quantitative mapping of gamification in health education through a bibliometric analysis of its publications. METHODS In this study, a total of 475 articles were analyzed by searching "health education*" and "gamif*" and similar terms from Web of Science and Scopus databases. R bibliometric package program was used for the analysis. 1971 authors contributed to the studies, which were spread between 2012 and 2024. The number of studies on gamification in the field of health education has grown in recent years. In particular, it was seen that 2018 can be seen as the breaking point and the highest number of publications was in 2023, with 101 publications. RESULTS The descriptive results showed that Zhang, X. was the most productive author, Nurse Education Today and BMC Medical Education were the most productive journals and the United States was the most productive country. It is concluded that terms such as gamification, medical education, game-based learning, education, serious games, simulation and e-learning are the most frequently used words in gamification studies in the field of health education. It has been observed that the concept of gamification is trending, especially in 2018-2023, with a frequency of 150 uses. CONCLUSIONS This study is expected to guide researchers in terms of key points for future research on gamification in health education contexts. It is expected that the knowledge provided by this study will enable researchers to be involved in this field and/or focus their research more effectively.
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Affiliation(s)
- Metin Yıldız
- Faculty of Health Sciences, Sakarya University, Sakarya, Turkey.
| | - Mehmet Yildiz
- Sakarya University of Applied Sciences, Distance Education Research and Application Center, Sakarya, Turkey.
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González-de la Torre H, Hernández-De Luis MN, Mies-Padilla S, Camacho-Bejarano R, Verdú-Soriano J, Rodríguez-Suárez CA. Effectiveness of "Escape Room" Educational Technology in Nurses' Education: A Systematic Review. NURSING REPORTS 2024; 14:1193-1211. [PMID: 38804424 PMCID: PMC11130902 DOI: 10.3390/nursrep14020091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms "Education, Nursing" and "Educational Technology", and the free term "Escape room", combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area.
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Affiliation(s)
- Héctor González-de la Torre
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | | | - Sergio Mies-Padilla
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain;
| | | | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), 03690 Alicante, Spain;
| | - Claudio-Alberto Rodríguez-Suárez
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
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Schmitz L, Betz CS, Böttcher A, Häußler SM, Praetorius M. [How much digitization do ENT curricula need? : Opportunities and limits from the perspective of students and teachers]. HNO 2024; 72:325-333. [PMID: 38372803 PMCID: PMC11045585 DOI: 10.1007/s00106-024-01437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Digitalization has long been an integral part of students' everyday lives and increasingly also of their medical training. It seems to be an unwritten law that "digital natives" want as much digitalization as possible. This study aims to shed more light on how students in the clinical phase of medical studies perceive the increasing digitalization of teaching and what they need for good education. MATERIALS AND METHODS This study analyzed two surveys that were conducted using an online questionnaire. On the one hand, students in the 5th-9th semesters of the medical faculty at the University of Hamburg (n = 282) were surveyed (survey 1). Another survey addressed all employees of ENT clinics in Germany (n = 175; survey 2). RESULTS A total of 76 students took part in survey 1 and 123 lecturers in survey 2. The results show that both students and lecturers do not want face-to-face teaching to be completely replaced by digital formats. A total of 72.7% of students reject the possibility of teaching practical skills through digital formats. The majority of students surveyed stated that offline formats improve their concentration (61.1%), participation probability (63.9%), and motivation to learn (76.6%). In contrast, 40.2% of lecturers see digitalization as a way to reduce the workload without any relevant loss in teaching quality. CONCLUSION Digital teaching formats have a negative impact on the medical education of the students surveyed. Interaction and physical presence are needed to increase the motivation to learn. This leads to the first conclusion that students are critical of the increasing digitalization of medical studies.
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Affiliation(s)
- Lisa Schmitz
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Christian S Betz
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Arne Böttcher
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Sophia M Häußler
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Mark Praetorius
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Chang SJ, Kim GM, Kim JA. The effects of flipped learning and gamification on nursing students' patient safety education: A mixed method study. Heliyon 2024; 10:e29538. [PMID: 38655326 PMCID: PMC11036057 DOI: 10.1016/j.heliyon.2024.e29538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Background The importance of enhancing education to promote nursing students' patient safety competency is increasing. Hence, implementing diverse educational programs and assessing their outcomes is essential. Objectives To examine the effects of flipped learning and gamification on nursing students' patient safety education. Design A mixed-method design employing a quasi-experimental design with a pre-post control group design and qualitative thematic analysis. Methods The study was conducted at a South Korean university in W City from September to December 2022. It included 55 s-year nursing students. The experimental group (n = 28) participated in a 30-h patient safety education course using flipped learning and gamification, whereas the control group (n = 27) received only written patient safety education materials. Learning motivation, collective efficacy, patient safety competency, and game evaluations were measured. Data were analyzed using the χ2 test, Fisher's exact test, t-test, repeated-measures multivariate analysis of covariance, repeated measure analysis of covariance, and generalized estimating equations. Self-reflection journals on game participation experiences were analyzed using qualitative thematic analysis. Results Learning motivation scores did not differ significantly between groups for time, or interactions between groups and time, but collective efficacy and patient safety competency scores showed significant differences in the interactions between groups and time. The experimental group showed a high satisfaction score in game evaluation. Qualitative analyses were used to extract four themes-three positives: "fun and immersion differentiated from existing classes," "improved the learning outcomes and learning motivation," and "realized the value of collaboration and communication," and one negative: "feeling down due to unfamiliarity." Conclusions This program creates positive learning experiences and enhances nursing students' collective efficacy and patient-safety competencies. It is expected to be utilized in various future nursing courses.
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Affiliation(s)
- Soo Jung Chang
- Department of Nursing, Gangneung-Wonju National University, South Korea
| | - Geun Myun Kim
- Department of Nursing, Gangneung-Wonju National University, South Korea
| | - Jeong Ah Kim
- Department of Nursing, Seoil University, South Korea
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Kayed JE, Akl T, Massoud C, Margossian C, Fayad H, Fares G, Felefly T, Rihana S. Serious game for radiotherapy training. BMC MEDICAL EDUCATION 2024; 24:463. [PMID: 38671374 PMCID: PMC11055359 DOI: 10.1186/s12909-024-05430-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Cancer patients are often treated with radiation, therefore increasing their exposure to high energy emissions. In such cases, medical errors may be threatening or fatal, inducing the need to innovate new methods for maximum reduction of irreversible events. Training is an efficient and methodical tool to subject professionals to the real world and heavily educate them on how to perform with minimal errors. An evolving technique for this is Serious Gaming that can fulfill this purpose, especially with the rise of COVID-19 and the shift to the online world, by realistic and visual simulations built to present engaging scenarios. This paper presents the first Serious Game for Lung Cancer Radiotherapy training that embodies Biomedical Engineering principles and clinical experience to create a realistic and precise platform for coherent training. METHODS To develop the game, thorough 3D modeling, animation, and gaming fundamentals were utilized to represent the whole clinical process of treatment, along with the scores and progress of every player. The model's goal is to output coherency and organization for students' ease of use and progress tracking, and to provide a beneficial educational experience supplementary to the users' training. It aims to also expand their knowledge and use of skills in critical cases where they must perform crucial decision-making and procedures on patients of different cases. RESULTS At the end of this research, one of the accomplished goals consists of building a realistic model of the different equipment and tools accompanied with the radiotherapy process received by the patient on Maya 2018, including the true beam table, gantry, X-ray tube, CT Scanner, and so on. The serious game itself was then implemented on Unity Scenes with the built models to create a gamified authentic environment that incorporates the 5 main series of steps; Screening, Contouring, External Beam Planning, Plan Evaluation, Treatment, to simulate the practical workflow of an actual Oncology treatment delivery for lung cancer patients. CONCLUSION This serious game provides an educational and empirical space for training and practice that can be used by students, trainees, and professionals to expand their knowledge and skills in the aim of reducing potential errors.
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Affiliation(s)
- Jessika El Kayed
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | - Tony Akl
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | - Chadi Massoud
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon.
- Faculty of Public Health, Université La Sagesse, Furn-El-Chebak, Lebanon.
| | - Christelle Margossian
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | | | - Georges Fares
- Radiation Oncology Department, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
- Radiation Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Tony Felefly
- Radiation Oncology Department, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
- Radiation Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Sandy Rihana
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon.
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Hu H, Lai X, Yan L. Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis. BMC MEDICAL EDUCATION 2024; 24:432. [PMID: 38649943 PMCID: PMC11034038 DOI: 10.1186/s12909-024-05442-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options. METHODS The design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed. RESULTS There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group. CONCLUSIONS The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load.
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Affiliation(s)
- Hai Hu
- Emergency Management Office of West China Hospital, Sichuan University, The street address: No. 37. Guoxue Road, Chengdu City, Sichuan Province, China.
- China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China.
- Emergency Medical Rescue Base, Sichuan University, Chengdu City, Sichuan Province, China.
| | - Xiaoqin Lai
- China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China
- Day Surgery Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
- Department of Thoracic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Longping Yan
- West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, China
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Skinner G, Chen T, Jentis G, Liu Y, McCulloh C, Harzman A, Huang E, Kalady M, Kim P. Real-time near infrared artificial intelligence using scalable non-expert crowdsourcing in colorectal surgery. NPJ Digit Med 2024; 7:99. [PMID: 38649447 PMCID: PMC11035672 DOI: 10.1038/s41746-024-01095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
Surgical artificial intelligence (AI) has the potential to improve patient safety and clinical outcomes. To date, training such AI models to identify tissue anatomy requires annotations by expensive and rate-limiting surgical domain experts. Herein, we demonstrate and validate a methodology to obtain high quality surgical tissue annotations through crowdsourcing of non-experts, and real-time deployment of multimodal surgical anatomy AI model in colorectal surgery.
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Affiliation(s)
- Garrett Skinner
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Activ Surgical, University at Buffalo, Buffalo, NY, USA
| | - Tina Chen
- Activ Surgical, University at Buffalo, Buffalo, NY, USA
| | | | - Yao Liu
- Activ Surgical, University at Buffalo, Buffalo, NY, USA
- Warren Alpert Medical School Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Alan Harzman
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Emily Huang
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Matthew Kalady
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Peter Kim
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
- Activ Surgical, University at Buffalo, Buffalo, NY, USA.
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Jørgensen T, Rosenkrantz O, Eberhard KE, Jensen TW, Dieckmann P. Perceptions of medical students on narrow learning objectives and structured debriefing in medical escape rooms: a qualitative study. BMC MEDICAL EDUCATION 2024; 24:403. [PMID: 38605342 PMCID: PMC11010419 DOI: 10.1186/s12909-024-05295-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/11/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants' experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing. METHODS In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned "exchange of information" and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation. RESULTS Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach. CONCLUSIONS Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students. CLINICAL TRIALS Clinical.trials ID NCT04783259.
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Affiliation(s)
- Tami Jørgensen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark.
- Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark.
| | - Oscar Rosenkrantz
- Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark
- Department of Anaesthesia, Center of Head and Orthopaedics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Kristine Elisabeth Eberhard
- Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark
- Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Theo Walther Jensen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark
- Prehospital Center, Region Zealand, Denmark
| | - Peter Dieckmann
- Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen , Denmark
- Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
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Chamouard V, Freyssenge J, Clairaz-Mahiou B, Ferrera Bibas F, Fraticelli L. Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study. JMIR Form Res 2024; 8:e54656. [PMID: 38574351 PMCID: PMC11027057 DOI: 10.2196/54656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab. OBJECTIVE This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program. METHODS The methodology is based on Kirkpatrick's model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3). RESULTS The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists. CONCLUSIONS This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease. TRIAL REGISTRATION ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/43091.
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Affiliation(s)
- Valérie Chamouard
- Louis Pradel Hospital, Groupement Hospitalier Est, Hospices Civils de Lyon, French Reference Center of Hemophilia, Bron, France
| | - Julie Freyssenge
- University Claude Bernard Lyon 1, INSERM U1290 Research on Healthcare Performance RESHAPE, Lyon, France
| | | | | | - Laurie Fraticelli
- Laboratory P2S (Health Systemic Process), UR 4129, University Claude Bernard Lyon 1, Lyon, France
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Cavioni V, Conte E, Ornaghi V. Promoting teachers' wellbeing through a serious game intervention: a qualitative exploration of teachers' experiences. Front Psychol 2024; 15:1339242. [PMID: 38601821 PMCID: PMC11004468 DOI: 10.3389/fpsyg.2024.1339242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Teachers' wellbeing plays a critical role in their overall job satisfaction, motivation, and effectiveness in building supporting learning environments. In today's dynamic educational settings, where teachers often face numerous challenges and stressors, their wellbeing becomes increasingly vital. Consequently, there is an urgent need to innovate and develop targeted training interventions that can support specifically the wellbeing of educators. Methods This study sought to provide an overview of the "Online Wellbeing Course - OWC," a serious game developed to enhance teachers' wellbeing, and to investigate the participants' feedback after being engaged in the OWC, utilizing a qualitative approach through focus group discussions. A total of 189 in-service teachers took part in the study. To qualitatively explore their experiences with the OWC, participants were involved in focus groups and asked to provide feedback about how and to what extent the course was beneficial for their wellbeing. Results Teachers reported enhancements in areas such as emotional competence, self-care strategies, social awareness, relationship skills, decision-making, and school climate. Discussion These outcomes suggested the potential of serious games as an innovative training approach for supporting teachers' wellbeing, offering valuable insights for researchers, policymakers, and educators.
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Affiliation(s)
- Valeria Cavioni
- Department of Social Sciences, University of Foggia, Foggia, Italy
| | - Elisabetta Conte
- Department of Human Sciences for Education “Riccardo Massa”, University of Milano-Bicocca, Milan, Italy
| | - Veronica Ornaghi
- Department of Human Sciences for Education “Riccardo Massa”, University of Milano-Bicocca, Milan, Italy
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Martínez-Galiano JM, Gonzalez-Cabrera M, Rodriguez-Almagro J, Hernández-Martínez A. Evaluation of Knowledge and Competencies in Sexual and Reproductive Health Care Using an Escape Room with Scenario Simulations. NURSING REPORTS 2024; 14:683-694. [PMID: 38525698 PMCID: PMC10961789 DOI: 10.3390/nursrep14020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024] Open
Abstract
To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered.
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Affiliation(s)
- Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, 23071 Jaén, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | | | - Julian Rodriguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.R.-A.); (A.H.-M.)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.R.-A.); (A.H.-M.)
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Padilha JM, Costa P, Sousa P, Ferreira A. Clinical virtual simulation: predictors of user acceptance in nursing education. BMC MEDICAL EDUCATION 2024; 24:299. [PMID: 38493087 PMCID: PMC10943828 DOI: 10.1186/s12909-024-05154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Using virtual patients integrated in simulators expands students' training opportunities in healthcare. However, little is known about the usability perceived by students and the factors/determinants that predict the acceptance and use of clinical virtual simulation in nursing education. OBJECTIVES To identify the factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing education. METHODS Observational, cross-sectional, analytical study of the use of clinical virtual simulation in nursing to answer the research question: What factors/determinants predict the acceptance and use of a clinical virtual simulator in nursing education? We used a non-probabilistic sampling, more specifically a convenience sample of nursing degree students. The data were collected through a questionnaire adapted from the Technology Acceptance Model 3. In technology and education, the Technology Acceptance Model is a theoretical model that predicts the acceptance of the use of technology by users. RESULTS The sample comprised 619 nursing students, who revealed mean values of perceived usefulness (M = 5.34; SD = 1.19), ease of use (M = 4.74; SD = 1.07), and intention to use the CVS (M = 5.21; SD = 1.18), in a Likert scale of seven points (1-the worst and 7 the best possible opinion). This study validated the use of Technology Acceptance Model 3 adapted and tested the related hypotheses, showing that the model explains 62% of perceived utility, 32% of ease of use, and 54% of intention to use the clinical virtual simulation in nursing by nursing students. The adequacy of the model was tested by analysis of the direct effects of the relationships between the internal constructs (PU-BI, β = 0.11, p = 0.012; PEOU-BI, β = -0.11, p = 0.002) and the direct relations between some of the constructs internal to the Technology Acceptance Model 3 and the external determinants Relevance for learning and Enjoyability. In the proposed model, the external constructs that best predicted perceived usefulness, ease of use, and behaviour intention to use the clinical virtual simulation in nursing were Relevance for learning and Enjoyability. CONCLUSIONS These study results allowed us to identify relevance for learning and enjoyability as the main factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing.
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Affiliation(s)
- José Miguel Padilha
- Nursing School of Porto, CINTESIS@RISE, Porto, Portugal.
- Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Paulino Sousa
- Nursing School of Porto, CINTESIS@RISE, Porto, Portugal
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Delage C, Palayer M, Lerouet D, Besson VC. "Pharmacotrophy": a playful tournament for game- and team-based learning in pharmacology education - assessing its impact on students' performance. BMC MEDICAL EDUCATION 2024; 24:219. [PMID: 38429772 PMCID: PMC10908103 DOI: 10.1186/s12909-024-05157-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND At the Faculty of Pharmacy of Paris, we conducted a pharmacology tournament in 2021 and 2022, named "Pharmacotrophy", to offer a game-, team- and competitive-based learning innovation based on fun and challenge. This article aims to (1) provide a detailed overview of the organisation of "Pharmacotrophy," (2) present and compare feedback from both students and teachers, and (3) assess the impact of student participation on their exam marks. METHODS "Pharmacotrophy" took place in 2021 and 2022 over a two-week period at the beginning of the exam revision phase. It involved a combination of remote matches using the online quiz creation tool Kahoot!® and in-person matches. Teams, consisting of three students from the 4th or 5th year, participated in several selection rounds leading up to the final match. The questions covered various topics from the pharmacology curriculum. Using an anonymous online survey, we collected the feedback from students and teacher regarding the organisation of the tournament and the interest and difficulty of the different type of questions. We retrospectively compared the exam marks of 4th year students who took part in "Pharmacotrophy" (n2021 = 19 and n2022 = 20) with those of the rest of the 4th year (n2021 = 315-320 and n2022 = 279-281), both in the year before "Pharmacotrophy" and just after the tournament. RESULTS Students highlighted the educational benefits of team-based and game-based learning. This novel approach positively and constructively motivated students to review pharmacology. Additionally, students appreciated the establishment of a trust-based relationship with their teachers. All students had a similar pharmacology level based on their exam results in the year before "Pharmacotrophy." After the tournament, participants had marks 20.1% higher in pharmacology questions compared to non-participants (p = 0.02), while they had comparable overall levels, as evidenced by their final grade averages and marks in non-pharmacology questions. Moreover, participants who advanced further in the competition achieved higher marks in pharmacology questions compared to those who were eliminated early in the tournament. CONCLUSION The implementation of "Pharmacotrophy" provided students with an enjoyable way to review pharmacology coursework and revived the interest in pharmacology for some. Specifically, participating in "Pharmacotrophy" led to an increase in pharmacology marks for students who were not among the top performers in the class or did not excel in pharmacology in the previous year. This study quantified the pedagogical value of this innovative curriculum in terms of knowledge acquisition.
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Affiliation(s)
- Clément Delage
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France.
- Service de Pharmacie, AP-HP, Hôpital Lariboisière-Fernand Widal, F-75010, Paris, France.
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France.
| | - Maeva Palayer
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
| | - Dominique Lerouet
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
| | - Valérie C Besson
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
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Tingelhoff PD, Hufert F, Kiessling C, Otto B. Infection prevention in medical education - results of a descriptive cross-sectional study in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc4. [PMID: 38504860 PMCID: PMC10946213 DOI: 10.3205/zma001659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/02/2023] [Accepted: 11/22/2023] [Indexed: 03/21/2024]
Abstract
Objective The aim of the study was to assess the current curricular status of content on infection prevention in hospitals during medical education prior to the development of a serious game on infection prevention in hospitals. In addition, the data collected was to be contrasted with the training for a specialist nurse in hygiene and infection prevention (FKHI). Methodology In an online survey, persons in charge of medical degree programs and continuing education centers for FKHI, SkillsLabs and professional associations in Germany were asked to answer 28 questions on framework conditions, teaching, examinations, and gamification. Results Data was collected for 22 medical degree programs and 5 FKHI continuing education centers. Due to the low response rate, the data for the FKHI was only analyzed in summary form. On average, 13.5 teaching units (median) are available in medical studies. Six degree programs have a longitudinal curriculum. In 7 of the 22 degree programs, teaching is based on the National Competency-Based Learning Objectives Catalogue (NKLM). Almost all locations teach this content in lectures (n=18) and/or in internships (n=13). Teaching and examinations are most common in the third year of study (n=12). In addition to practical OSCE examinations (n=5), written (n=12) and computer-based (n=8) examinations are used in particular. Gamification is known as a didactic approach to some extent but is not used for teaching infection prevention. Conclusions Infection prevention in hospitals is given relatively low priority in medical education. Teaching and examinations are based on traditional knowledge-oriented formats, although practical teaching and practical examinations are established at some locations. In contrast to the FKHI, learning objectives currently appear to be less standardized. Further interprofessional development of teaching would be desirable in the future.
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Affiliation(s)
- Paul-Dierk Tingelhoff
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Frank Hufert
- Brandenburg Medical School Theodor Fontane Senftenberg, Institute of Microbiology and Virology, Senftenberg, Germany
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Bertram Otto
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
- Klinikum Ernst von Bergmann, Clinic for Gastroenterology, Hepatology, Infectiology and Rheumatology, Klinikum Potsdam, Germany
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Speck I, Merk A, Burkhardt V, O F, Huber C, Widder A, Everad F, Offergeld C. Virtual reality cricothyrotomy - a case-control study on gamification in emergency education. BMC MEDICAL EDUCATION 2024; 24:148. [PMID: 38360638 PMCID: PMC10868043 DOI: 10.1186/s12909-024-05133-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Cricothyrotomy is an invasive and rare emergency intervention to secure the airway in a "cannot intubate, cannot ventilate" situation. This leads to lack of routine. Cricothyrotomy is performed only hesitantly. Therefore, we aim to improve teaching by including a virtual reality (VR) cricothyrotomy as a learning tool. METHODS We programmed the VR cricothyrotomy in the C# programming language on the open-source Unity platform. We could include 149 students that we randomly assigned to either a study group (VR cricothyrotomy) or control group (educational video). We asked the study group to subjectively rate the VR cricothyrotomy. To evaluate our intervention (VR cricothyrotomy) we took the time participants needed to perform a cricothyrotomy on a plastic model of a trachea and evaluated the correct procedural steps. RESULTS The majority of students that performed the VR simulation agreed that they improved in speed (81%) and procedural steps (92%). All participants completed the cricothyrotomy in 47s ± 16s and reached a total score of 8.7 ± 0.7 of 9 possible points. We saw no significant difference in time needed to perform a cricothyrotomy between study and control group (p > 0.05). However, the total score of correct procedural steps was significantly higher in the study group than in the control group (p < 0.05). CONCLUSIONS Virtual reality is an innovative learning tool to improve teaching of emergency procedures. The VR cricothyrotomy subjectively and objectively improved correct procedural steps. Digitized education fills an educational gap between pure haptic experience and theoretical knowledge. This is of great value when focusing on extension of factual knowledge. TRIAL REGISTRATION DRKS00031736, registered on the 20th April 2023.
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Affiliation(s)
- I Speck
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
| | - A Merk
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - V Burkhardt
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Flayyih O
- Dean's Office for Human Medicine, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Breisacher Straße 153, 79110, Freiburg, Germany
| | - C Huber
- Dean's Office for Human Medicine, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Breisacher Straße 153, 79110, Freiburg, Germany
| | - A Widder
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - F Everad
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - C Offergeld
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
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Hu J, Sonnleitner M, Weldon E, Kejriwal S, Brown B, Shah A. An Escape Room to Teach First- and Second-Year Medical Students Nephrology. MEDICAL SCIENCE EDUCATOR 2024; 34:71-76. [PMID: 38510392 PMCID: PMC10948694 DOI: 10.1007/s40670-023-01917-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 03/22/2024]
Abstract
An escape room is a team-based activity that requires players to solve a series of puzzles to complete a story and "break out" of a room. It has recently gained traction in medical education for its ability to interactively and effectively present learning objectives. This was a prospective educational study that describes the successful application of a nephrology themed escape room for first- and second-year medical students. Compared to pre-escape room participation, the 52 students demonstrated a statistically significant improvement in self-reported knowledge for renal physiology (p < 0.01), pharmacology (p < 0.01), pathology (p < 0.01), and relevant clinical practice guidelines (p < 0.01). A majority of the students also claimed that the escape room was "more effective" than traditional lectures (80.8%) and textbooks (73.1%) and "equally effective" as third-party board preparation resources (69.2%) and their institution's problem-based learning curriculum (51.9%). The escape room also facilitated a high-level peer-to-peer collaboration with 82.7% and 76.9% of students reporting that they worked with someone in their year and outside of their year for at least half of the game, respectively. Ninety-five percent of the first-years and 84.6% of the second-years believed that the escape room was effective at preparing them for their respective exams, and an overwhelming majority (90.4%) described the escape room as "very enjoyable." Overall, this nephrology themed escape room was an engaging and well received educational modality and may be an effective supplemental study resource for medical students. Further studies are needed to assess knowledge acquisition. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01917-6.
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Affiliation(s)
- Jonathan Hu
- University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
| | | | - Edward Weldon
- University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
| | - Sameer Kejriwal
- University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
| | - Bryan Brown
- University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
- The Queen’s Medical Center, Honolulu, HI USA
| | - Ashish Shah
- San Diego School of Medicine, University of California, San Diego, CA USA
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Bahadur AG, Hargreaves F, Antinucci R, Sockalingam S, Abdool PS. Virtual Reality Simulation for Suicide Risk Assessment Training: Prevalence of Adverse Effects. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:57-60. [PMID: 37258946 DOI: 10.1007/s40596-023-01799-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Virtual reality (VR) simulation is changing the landscape of simulation-based medical education. Immersive VR allows users to interact with a computer-generated environment and digital avatars using a VR headset and controllers. However, current literature regarding the use of immersive VR simulation in psychiatric medical education is sparse. This study describes its use and considerations regarding tolerability. METHODS At a mental health hospital in Canada, two immersive VR suicide risk assessment (SRA) case simulations were developed. These simulations have participants interview VR patients to characterize their suicide risk, offering a novel and safe way to engage healthcare providers in SRA training. Regarding user tolerability of these VR simulations, the Simulator Sickness Questionnaire (SSQ) was administered to participants after the simulation to characterize any motion sickness symptoms experienced. RESULTS Of the 22 participants in this study, the overall SSQ scores demonstrated good tolerability of the VR SRA, with the majority of participants reporting no or minimal simulator sickness symptoms. Moreover, the majority of participants reported being satisfied with this training and that the VR SRA simulation enhanced their learning experience. CONCLUSION These study findings are novel, given the current dearth of data regarding the use of immersive VR in simulation-based psychiatric medical education. Further studies exploring the educational effectiveness of VR SRA in simulation-based psychiatric medical education are indicated.
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Affiliation(s)
| | | | - Rachel Antinucci
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Petal S Abdool
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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24
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Noël F, Xexéo G, Martins M, Silva E, Pupo A, Magalhães P, Lima-Júnior R, Gadelha K, Lima-Silva K, Raimundo J, Ghedini P, Crespo-Lopez M, Arrifano G, Ferreira J, Prediger R, Militão G, Oliveira R, Hollais A, Rodrigues L, Carvalho D, Costa S, Martins D. Assessing the reaction to and efficacy of the Screener drug discovery and development board game as a pedagogical tool in postgraduate courses. Braz J Med Biol Res 2024; 57:e13258. [PMID: 38265347 PMCID: PMC10802222 DOI: 10.1590/1414-431x2023e13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/15/2023] [Indexed: 01/25/2024] Open
Abstract
Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.
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Affiliation(s)
- F. Noël
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - G. Xexéo
- Laboratório de Ludologia, Engenharia e Simulação, Programa de Engenharia de Sistemas e Computação, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - M.A. Martins
- Laboratório de Inflamação, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - E.J.R. Silva
- Departamento de Biofísica e Farmacologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - A.S. Pupo
- Departamento de Biofísica e Farmacologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - P.J.C. Magalhães
- Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - R.C.P. Lima-Júnior
- Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - K.K.L. Gadelha
- Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - K. Lima-Silva
- Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - J.M. Raimundo
- Grupo de Pesquisa em Farmacologia de Produtos Bioativos, Centro Multidisciplinar UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé, RJ, Brasil
| | - P.C. Ghedini
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - M.E. Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil
| | - G.P. Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil
| | - J. Ferreira
- Programa de Pós-graduação em Farmacologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - R.D. Prediger
- Programa de Pós-graduação em Farmacologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - G.C.G. Militão
- Departamento de Fisiologia e Farmacologia, Centro de Biociências, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - R.B. Oliveira
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - A.W. Hollais
- Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - L.C.M. Rodrigues
- Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - D.T. Carvalho
- Faculdade de Ciências Farmacêuticas, Universidade Federal de Alfenas, Alfenas, MG, Brasil
| | - S.K.P. Costa
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brasil
| | - D.T.O. Martins
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Farmacologia, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
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Tolks D, Schmidt JJ, Kuhn S. The Role of AI in Serious Games and Gamification for Health: Scoping Review. JMIR Serious Games 2024; 12:e48258. [PMID: 38224472 PMCID: PMC10825760 DOI: 10.2196/48258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI) and game-based methods such as serious games or gamification are both emerging technologies and methodologies in health care. The merging of the two could provide greater advantages, particularly in the field of therapeutic interventions in medicine. OBJECTIVE This scoping review sought to generate an overview of the currently existing literature on the connection of AI and game-based approaches in health care. The primary objectives were to cluster studies by disease and health topic addressed, level of care, and AI or games technology. METHODS For this scoping review, the databases PubMed, Scopus, IEEE Xplore, Cochrane Library, and PubPsych were comprehensively searched on February 2, 2022. Two independent authors conducted the screening process using Rayyan software (Rayyan Systems Inc). Only original studies published in English since 1992 were eligible for inclusion. The studies had to involve aspects of therapy or education in medicine and the use of AI in combination with game-based approaches. Each publication was coded for basic characteristics, including the population, intervention, comparison, and outcomes (PICO) criteria; the level of evidence; the disease and health issue; the level of care; the game variant; the AI technology; and the function type. Inductive coding was used to identify the patterns, themes, and categories in the data. Individual codings were analyzed and summarized narratively. RESULTS A total of 16 papers met all inclusion criteria. Most of the studies (10/16, 63%) were conducted in disease rehabilitation, tackling motion impairment (eg, after stroke or trauma). Another cluster of studies (3/16, 19%) was found in the detection and rehabilitation of cognitive impairment. Machine learning was the main AI technology applied and serious games the main game-based approach used. However, direct interaction between the technologies occurred only in 3 (19%) of the 16 studies. The included studies all show very limited quality evidence. From the patients' and healthy individuals' perspective, generally high usability, motivation, and satisfaction were found. CONCLUSIONS The review shows limited quality of evidence for the combination of AI and games in health care. Most of the included studies were nonrandomized pilot studies with few participants (14/16, 88%). This leads to a high risk for a range of biases and limits overall conclusions. However, the first results present a broad scope of possible applications, especially in motion and cognitive impairment, as well as positive perceptions by patients. In future, the development of adaptive game designs with direct interaction between AI and games seems promising and should be a topic for future reviews.
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Affiliation(s)
- Daniel Tolks
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
| | - Johannes Jeremy Schmidt
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
| | - Sebastian Kuhn
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
- Institute for Digital Medicine, University Clinic of Gießen und Marburg, Philipps University Marburg, Marburg, Germany
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Rovati L, Gary PJ, Cubro E, Dong Y, Kilickaya O, Schulte PJ, Zhong X, Wörster M, Kelm DJ, Gajic O, Niven AS, Lal A. Development and usability testing of a patient digital twin for critical care education: a mixed methods study. Front Med (Lausanne) 2024; 10:1336897. [PMID: 38274456 PMCID: PMC10808677 DOI: 10.3389/fmed.2023.1336897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background Digital twins are computerized patient replicas that allow clinical interventions testing in silico to minimize preventable patient harm. Our group has developed a novel application software utilizing a digital twin patient model based on electronic health record (EHR) variables to simulate clinical trajectories during the initial 6 h of critical illness. This study aimed to assess the usability, workload, and acceptance of the digital twin application as an educational tool in critical care. Methods A mixed methods study was conducted during seven user testing sessions of the digital twin application with thirty-five first-year internal medicine residents. Qualitative data were collected using a think-aloud and semi-structured interview format, while quantitative measurements included the System Usability Scale (SUS), NASA Task Load Index (NASA-TLX), and a short survey. Results Median SUS scores and NASA-TLX were 70 (IQR 62.5-82.5) and 29.2 (IQR 22.5-34.2), consistent with good software usability and low to moderate workload, respectively. Residents expressed interest in using the digital twin application for ICU rotations and identified five themes for software improvement: clinical fidelity, interface organization, learning experience, serious gaming, and implementation strategies. Conclusion A digital twin application based on EHR clinical variables showed good usability and high acceptance for critical care education.
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Affiliation(s)
- Lucrezia Rovati
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Phillip J. Gary
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Edin Cubro
- Department of Information Technology, Mayo Clinic, Rochester, MN, United States
| | - Yue Dong
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Oguz Kilickaya
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Phillip J. Schulte
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
| | - Xiang Zhong
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, United States
| | - Malin Wörster
- Center for Anesthesiology and Intensive Care Medicine, Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Diana J. Kelm
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ognjen Gajic
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Alexander S. Niven
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Amos Lal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
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Huang WD, Loid V, Sung JS. Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022. BMC MEDICAL EDUCATION 2024; 24:20. [PMID: 38172852 PMCID: PMC10765768 DOI: 10.1186/s12909-023-04955-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy. METHODS Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded. RESULTS Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs. CONCLUSION These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.
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Affiliation(s)
- Wenhao David Huang
- Biomedical and Translational Science, Carle-Illinois College of Medicine; Education Policy, Organization, and Leadership, College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA.
| | - Viktoria Loid
- Education Policy, Organization, and Leadership College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Jung Sun Sung
- Education Policy, Organization, and Leadership College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA
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28
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Masters K, Correia R, Nemethy K, Benjamin J, Carver T, MacNeill H. Online learning in health professions education. Part 2: Tools and practical application: AMEE Guide No. 163. MEDICAL TEACHER 2024; 46:18-33. [PMID: 37740948 DOI: 10.1080/0142159x.2023.2259069] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Part 1 of the AMEE Guide Online learning in health professions education focused on foundational concepts such as theory, methods, and instructional design in online learning. Part 2 builds upon Part 1, introducing technology tools and applications of these foundational concepts by exploring the various levels (from beginner to advanced) of utilisation, while describing how their usage can transform Health Professions Education. This Part covers Learning Management Systems, infographics, podcasting, videos, websites, social media, online discussion forums, simulation, virtual patients, extended and virtual reality. Intertwined are other topics, such as online small group teaching, game-based learning, FOAM, online social and collaboration learning, and virtual care teaching. We end by discussing digital scholarship and emerging technologies. Combined with Part 1, the overall aim of Part 2 is to produce a comprehensive overview to help guide effective use online learning in Health Professions Education.
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Affiliation(s)
- Ken Masters
- Medical Education and Informatics Department, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
| | | | - Kataryna Nemethy
- Baycrest Academy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jennifer Benjamin
- Department of Education Innovation and Technology, Texas Childrens Hospital (TCH), Texas, USA
| | | | - Heather MacNeill
- Department of Medicine, Continuing Professional Development, University of Toronto, Toronto, Canada
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Bass GA, Chang CWJ, Sorce LR, Subramanian S, Laytin AD, Somodi R, Gray JR, Lane-Fall M, Kaplan LJ. Gamification in Critical Care Education and Practice. Crit Care Explor 2024; 6:e1034. [PMID: 38259864 PMCID: PMC10803028 DOI: 10.1097/cce.0000000000001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVES To explore gamification as an alternative approach to healthcare education and its potential applications to critical care. DATA SOURCES English language manuscripts addressing: 1) gamification theory and application in healthcare and critical care and 2) implementation science focused on the knowledge-to-practice gap were identified in Medline and PubMed databases (inception to 2023). STUDY SELECTION Studies delineating gamification underpinnings, application in education or procedural mentoring, utilization for healthcare or critical care education and practice, and analyses of benefits or pitfalls in comparison to other educational or behavioral modification approaches. DATA EXTRACTION Data indicated the key gamification tenets and the venues within which they were used to enhance knowledge, support continuing medical education, teach procedural skills, enhance decision-making, or modify behavior. DATA SYNTHESIS Gamification engages learners in a visual and cognitive fashion using competitive approaches to enhance acquiring new knowledge or skills. While gamification may be used in a variety of settings, specific design elements may relate to the learning environment or learner styles. Additionally, solo and group gamification approaches demonstrate success and leverage adult learning theory elements in a low-stress and low-risk setting. The potential for gamification-driven behavioral modification to close the knowledge-to-practice gap and enable guideline and protocol compliance remains underutilized. CONCLUSIONS Gamification offers the potential to substantially enhance how critical care professionals acquire and then implement new knowledge in a fashion that is more engaging and rewarding than traditional approaches. Accordingly, educational undertakings from courses to offerings at medical professional meetings may benefit from being gamified.
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Affiliation(s)
- Gary Alan Bass
- Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Lauren R Sorce
- Department of Pediatrics (Critical Care), Northwestern University, Chicago, IL
| | - Sanjay Subramanian
- Department of Anesthesiology, Critical Care Medicine, Washington University in St. Louis, St. Louis, MO
- Omnicure Inc., St. Louis, MO
| | - Adam D Laytin
- Departments of Anesthesia and Critical Care Medicine and Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Reka Somodi
- Section of Surgical Critical Care, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Jaime R Gray
- Department of Pharmacy, Temple University Health System, Philadelphia, PA
| | - Meghan Lane-Fall
- Departments of Anesthesiology and Critical Care Medicine and Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lewis J Kaplan
- Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Do M, Sanford K, Roseff S, Hovaguimian A, Besche H, Fischer K. Gamified versus non-gamified online educational modules for teaching clinical laboratory medicine to first-year medical students at a large allopathic medical school in the United States. BMC MEDICAL EDUCATION 2023; 23:959. [PMID: 38098014 PMCID: PMC10720092 DOI: 10.1186/s12909-023-04951-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Medical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students. METHODS First-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The "gamified" module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey. RESULTS One hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment. CONCLUSIONS In this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.
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Affiliation(s)
- Marie Do
- Department of Pathology, Virginia Commonwealth University, 1101 E. Marshall Street, Box 980662, Richmond, VA, 23298, USA.
| | - Kimberly Sanford
- Department of Pathology, Virginia Commonwealth University, 1101 E. Marshall Street, Box 980662, Richmond, VA, 23298, USA
| | - Susan Roseff
- Department of Pathology, Virginia Commonwealth University, 1101 E. Marshall Street, Box 980662, Richmond, VA, 23298, USA
| | - Alexandra Hovaguimian
- Department of Neurology, Beth Israel Deaconess Medical Center (BIDMC), 330 Brookline Avenue, Shapiro 8, Boston, MA, 02215, USA
| | - Henrike Besche
- Harvard Medical School, 260 Longwood Avenue TMEC368, Boston, MA, 02115, USA
| | - Krisztina Fischer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 260 Longwood Ave, Rm 160, Boston, MA, 02115, USA
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Tomlin D, Bowers P, Graydon K. E-Learning Simulations for Teaching Clinical Decision-Making in an Audiology Training Program. Am J Audiol 2023; 32:878-888. [PMID: 37678161 DOI: 10.1044/2023_aja-22-00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
PURPOSE Clinical decision-making is an essential component of most clinical processes across the health sector and an ongoing challenge for clinical education programs to teach to students. The traditional methods of teaching these skills outside of lectures are mainly through clinical placements and problem-based learning (PBL) sessions, but availability and consistency can be variable and resource heavy. To address these challenges, an e-simulation module specific to pediatric infant diagnostic testing has been developed and implemented into the teaching program. We aimed to establish whether e-simulation resulted in student skill acquisition. METHOD Academic performance measures for 67 audiology students who used a traditional PBL and 108 students who used the e-simulation module were collected and analyzed. Student survey results generated both quantitative and qualitative data, which were analyzed using a thematic analysis with an inductive approach. RESULTS Findings indicated that the e-simulation platform introduced in this study yielded learning outcomes similar to the traditional PBL format previously used. Participants experienced a significant in situ increase in understanding of infant diagnostic testing concepts following the use of the e-simulation and evaluated the e-simulation platform positively. CONCLUSION The data support that an e-simulation-based approach in clinical education presents pedagogical benefits and can provide a meaningful sustainable inclusion in today's clinical teaching programs.
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Affiliation(s)
- Dani Tomlin
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | - Patrick Bowers
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | - Kelley Graydon
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
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Edwards S, Swamy L, Cosimini M, Watsjold B, Chan TM. Educator's blueprint: A how-to guide for creating analog serious games for learning in medical education. AEM EDUCATION AND TRAINING 2023; 7:e10907. [PMID: 38046091 PMCID: PMC10685402 DOI: 10.1002/aet2.10907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 12/05/2023]
Abstract
Serious games are an emerging tool for teaching and learning within medical education. These games can be used to facilitate learning or to demonstrate complex concepts in short bursts of interactive learning. This educator's blueprint will provide 10 strategies for creating a serious game, focusing on card and board games. These strategies include creating a project charter; determining the nature of the game; establishing game mechanics; selecting the best medium; prototyping and playtesting; reviewing sensitivity to equity, diversity, and inclusion; reviewing and refining content; funding game development, manufacture, and distribution; marketing and publicizing the game; and future-proofing the game. This blueprint hopes to help aspiring serious game designers and educators to conceptualize the steps for successfully creating a new serious game for medical education.
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Affiliation(s)
- Sarah Edwards
- Department of Emergency MedicineUniversity Hospitals of Nottingham, Queens Medical CentreNottinghamUK
| | - Lakshman Swamy
- Harvard Medical SchoolMassachusettsBostonUSA
- Department of Pulmonary and Critical Care MedicineCambridge Health AllianceMassachusettsCambridgeUSA
| | - Michael Cosimini
- Department of PediatricsOregon Health and Science UniversityOregonPortlandUSA
| | - Bjorn Watsjold
- Department of Emergency MedicineUniversity of WashingtonWashingtonSeattleUSA
| | - Teresa M. Chan
- School of MedicineToronto Metropolitan UniversityOntarioTorontoCanada
- Faculty of Health Sciences, Department of Medicine, Division of Emergency/Division of Education & InnovationMcMaster UniversityOntarioHamiltonCanada
- McMaster Education Reseach, Innovation, and Theory (MERIT) ProgramOntarioHamiltonCanada
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Garvick S, Gillette C, Bates N, Jackson T, Gao H, Crandall S. Physician Assistant Student Attitudes Toward Gamification of Cardiac Auscultation Instruction. J Physician Assist Educ 2023; 34:339-343. [PMID: 37678814 DOI: 10.1097/jpa.0000000000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Current physician assistant (PA) learners have a clear preference for interactive learning that is vibrantly present in new media technologies. At present, there is a paucity of research regarding use or acceptability of gamification in PA education. The purpose of this study was to examine PA students' experience with, attitudes toward, and outcomes of a gamified cardiac auscultation curriculum. METHODS Faculty at one institution designed an interactive Mobile App Cardiac Auscultation Curriculum (MACAC). The MACAC incorporates independent and group learning using the Littmann Learning mobile app. Author-created surveys as well as knowledge and auscultation assessment tools were delivered to all students. RESULTS Most of the students recommended the use of the app for future cohorts and reported confidence to accurately identify normal and abnormal heart sounds. Knowledge and auscultation assessment scores demonstrated proficiency in identification of normal and abnormal heart sounds. DISCUSSION Gamification research is important because blended learning that incorporates new media technologies with traditional approaches can help overcome the limitations of passive learning environments. This study provides evidence that the use of a mobile app can be an effective and innovative method to teach cardiac auscultation to the 21st century PA learners.
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Affiliation(s)
- Sarah Garvick
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Chris Gillette
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nathan Bates
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Toni Jackson
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Hong Gao
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sonia Crandall
- Sarah Garvick, MS, MPAS, PA-C, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Toni Jackson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Hong Gao, PhD, is an assistant professor, Department of General Internal Medicine, Wake Forest University School of Medicine Winston-Salem, North Carolina
- Sonia Crandall, PhD, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Pancio G, Kern N, Ankam N, Zhang XC. Impact of Exercise Prescription Education on Medical Student Confidence and Knowledge in Generating Exercise Recommendations. Cureus 2023; 15:e51396. [PMID: 38292992 PMCID: PMC10826447 DOI: 10.7759/cureus.51396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Despite physical activity being a key component of maintaining health and preventing disease progression, medical schools are not providing sufficient education on physical activity to medical students. As a result, medical students and new residents express a lack of confidence and knowledge when engaging in exercise prescription conversations with patients. A group of 20 first-year medical students at Sidney Kimmel Medical College (SKMC) attended a selective course on exercise prescription and the American College of Sports Medicine (ACSM) physical activity guidelines. The course included gamification and case-based learning; students were introduced to fitness-related health issues and discussed how to adapt fitness guidelines for unique patient populations, including geriatric and cardiovascular patients. Cases were supplemented with gym equipment for students to further explore both aerobic and strength components of ACSM guidelines. Students' confidence and knowledge of exercise prescription were assessed before and after the session via the Likert scale and case-vignette multiple-choice questions (MCQs), respectively. These surveys were also distributed to 18 SKMC first-year counterparts who did not participate in the course selection. Based on survey scores, students' post-course self-reported confidence was significantly greater than before the session (p=0.034) and greater than that of students who did not participate in the course (p=0.005). Students' knowledge increased and was significantly higher than that of course non-participants (p=0.018). This course highlighted that gamification and case-oriented education interventions can raise medical students' confidence in fitness in the hopes that they feel more comfortable providing exercise recommendations in the future.
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Affiliation(s)
| | - Nathaniel Kern
- Medicine, Thomas Jefferson University, Philadelphia, USA
| | - Nethra Ankam
- Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, USA
| | - Xiao Chi Zhang
- Emergency Medicine, Thomas Jefferson University, Philadelphia, USA
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dos Santos TT, Ríos MP, de Medeiros GCBS, Mata ÁNDS, Silva Junior DDN, Guillen DM, Piuvezam G. Gamification as a health education strategy of adolescents at school: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0294894. [PMID: 38033047 PMCID: PMC10688727 DOI: 10.1371/journal.pone.0294894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023] Open
Abstract
The objective of the study is to present a systematic review and meta-analysis protocol for evaluating the effects of health education gamification-based interventions, on health parameters (food consumption, sleep quality and physical activity) of adolescent students. This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022373833). The search will be performed in the following databases: MEDLINE, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, APA, and ADOLEC. Intervention studies (clinical trials - randomized or non-randomized) and quasi-experimental studies will be included. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomized controlled trials, non- randomized controlled trials and quasi-experimental trials. Two independent researchers will conduct all assessments, and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed using RevMan 5.4.1 software. We will conduct the study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guideline. The review will summarize the current evidence on gamification health education changes in parameters related to the health of adolescents. Gamification has been used to verify the increase in adherence to healthy habits or the development of health-related skills, but there are still few results for the adolescent population. We expect that the systematic review could indicate strategies with gamification interventions and also determine how these strategies can improve health parameters of adolescent students, and they will be available as a reference for these interventions.
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Affiliation(s)
- Thais Teixeira dos Santos
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Gidyenne Christine Bandeira Silva de Medeiros
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ádala Nayana de Sousa Mata
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Multicampi School of Medical Sciences of Rio Grande do Norte (EMCM), Federal University of Rio Grande do Norte, Caicó, Brazil
| | - Danyllo do Nascimento Silva Junior
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Grasiela Piuvezam
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Public Health, Federal University of Rio Grande do Norte (UFRN-Brazil), Natal, Brazil
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Taghipour E, Vizeshfar F, Zarifsanaiey N. The effect of gamification-based training on the knowledge, attitudes, and academic achievement of male adolescents in preventing substance and internet addiction. BMC MEDICAL EDUCATION 2023; 23:860. [PMID: 37957670 PMCID: PMC10641928 DOI: 10.1186/s12909-023-04858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 11/08/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Preventing addiction through training takes precedence over treatment and plays a crucial role in enhancing the well-being of adolescents. Utilizing inclusive and participatory methods can significantly enhance the effectiveness of education. Numerous studies have demonstrated that gamification, as an interactive and comprehensive approach, has the potential to boost teenagers' motivation to engage in learning and contributes to better comprehension. AIM This study aimed to assess the impact of gamification-based training to prevent substance and internet addiction on the knowledge and attitudes of male adolescents. Additionally, the study examined this educational program's effects on male adolescents' academic achievement. METHODS This study employed a quasi-experimental design with a control group. One hundred fourteen male adolescents were randomly assigned to the intervention or control groups. They completed a pre-intervention questionnaire assessing addiction-related knowledge, attitudes, and academic achievement. Subsequently, the intervention group received the gamification-based drug and internet addiction prevention training. Post-tests were conducted immediately after the training and again one month later for both groups. RESULTS Before the intervention, there were no significant differences in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement between the intervention and control groups (P > 0.05). However, after the intervention, the intervention group demonstrated significantly higher scores in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement compared to the control group (P < 0.001). CONCLUSION The current study highlights the positive impact of gamification-based training on enhancing male adolescents' knowledge, attitudes, and academic achievement.
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Affiliation(s)
- Esmaeel Taghipour
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Vizeshfar
- Community-Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nahid Zarifsanaiey
- Department of E-learning, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Rudolphi-Solero T, Lorenzo-Álvarez R, Domínguez-Pinos D, Ruiz-Gómez MJ, Sendra-Portero F. An Interuniversity Competition for Medical Students to Learn Radiology in the Second Life Metaverse. J Am Coll Radiol 2023:S1546-1440(23)00842-6. [PMID: 37922968 DOI: 10.1016/j.jacr.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The aim of this study was to evaluate an interuniversity competition online to learn radiology held in a 3-D virtual world, the Second Life metaverse, by analyzing the results of the game and students' perceptions. METHODS Medical students voluntarily participated in teams of four, for 6 weeks, successively covering radiologic anatomy and radiologic semiology of the chest, abdomen, and musculoskeletal. Each week, participants had 4.5 days to study self-learning presentations and 2.5 days to complete an individual multiple-choice test and a team task, the results of which determined the game's ranking. Participants were asked to complete a cognitive-load test, a perception questionnaire, and a postexposure knowledge test. RESULTS The competition was repeated for 2 years (editions), in 2020 and 2021. Seventy-five of 102 teams (73.5%) registered completed the game; 76% of them included third-year students. The average percentage of correct answers in the individual tests and team tasks was 74.2 ± 15.1 and 71.6 ± 14.7 respectively, without significant differences between both competitions. In general, the experience was valued positively (scores >8 on a 10-point scale). A lower perception score was found in 2021 among students from universities other than the organizing university, showing a positive correlation with the in-game score. CONCLUSIONS An interuniversity competition in the Second Life metaverse for undergraduate learning radiology is feasible and reproducible. Participating medical students considered it interesting and useful and also identified this activity during the 2 years of the coronavirus disease 2019 pandemic as a playful learning and social interaction experience.
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Affiliation(s)
- Teodoro Rudolphi-Solero
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain. https://twitter.com/TeoRudSol
| | - Rocío Lorenzo-Álvarez
- Critical Care and Emergency Service, Hospital de la Axarquía, Velez-Malaga, Spain. https://twitter.com/estrellitadluz
| | - Dolores Domínguez-Pinos
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Miguel José Ruiz-Gómez
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Francisco Sendra-Portero
- Director, Department of Radiology and Physical Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain.
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Cuesta-Montero P, Navarro-Martínez J, Yedro M, Galiana-Ivars M. Sepsis and Clinical Simulation: What Is New? (and Old). J Pers Med 2023; 13:1475. [PMID: 37888086 PMCID: PMC10608191 DOI: 10.3390/jpm13101475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Sepsis is a critical and potentially fatal condition affecting millions worldwide, necessitating early intervention for improved patient outcomes. In recent years, clinical simulation has emerged as a valuable tool for healthcare professionals to learn sepsis management skills and enhance them. METHODS This review aims to explore the use of clinical simulation in sepsis education and training, as well as its impact on how healthcare professionals acquire knowledge and skills. We conducted a thorough literature review to identify relevant studies, analyzing them to assess the effectiveness of simulation-based training, types of simulation methods employed, and their influence on patient outcomes. RESULTS Simulation-based training has proven effective in enhancing sepsis knowledge, skills, and confidence. Simulation modalities vary from low-fidelity exercises to high-fidelity patient simulations, conducted in diverse settings, including simulation centers, hospitals, and field environments. Importantly, simulation-based training has shown to improve patient outcomes, reducing mortality rates and hospital stays. CONCLUSION In summary, clinical simulation is a powerful tool used for improving sepsis education and training, significantly impacting patient outcomes. This article emphasizes the importance of ongoing research in this field to further enhance patient care. The shift toward simulation-based training in healthcare provides a safe, controlled environment for professionals to acquire critical skills, fostering confidence and proficiency when caring for real sepsis patients.
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Affiliation(s)
- Pablo Cuesta-Montero
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Jose Navarro-Martínez
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Melina Yedro
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - María Galiana-Ivars
- Department of Anesthesiology and Surgical Critical Care, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
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Molina-Rodríguez A, Suárez-Cortés M, Leal-Costa C, Ruzafa-Martínez M, Díaz-Agea JL, Ramos-Morcillo AJ, Jiménez-Ruiz I. Including audience response systems in debriefing. A mixed study during nursing simulation-based learning. BMC Nurs 2023; 22:353. [PMID: 37789299 PMCID: PMC10548674 DOI: 10.1186/s12912-023-01499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation. METHODS A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed "ad hoc", on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale. RESULTS (1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was "Motivation", with a mean of 4.7 (SD = 0.480), followed by the dimension "Participation", with a mean of 4.66 (SD = 0.461), and lastly, the dimension "Attention", with a mean of 4.64 (SD = 0.418). CONCLUSIONS The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.
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Affiliation(s)
| | - María Suárez-Cortés
- Department of Nursing, Faculty of Nursing, University of Murcia, Murcia, Spain.
| | - César Leal-Costa
- Department of Nursing, Faculty of Nursing, University of Murcia, Murcia, Spain
| | | | - José Luis Díaz-Agea
- Department of Nursing, Faculty of Nursing, University of Murcia, Murcia, Spain
| | | | - Ismael Jiménez-Ruiz
- Department of Nursing, Faculty of Nursing, University of Murcia, Murcia, Spain
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Thesen T, Bahner I, Belovich AN, Bonaminio G, Brenneman A, Brooks WS, Chinn C, El-Sawi N, Habal S, Haight M, Haudek SB, Ikonne U, McAuley RJ, McKell D, Rowe R, Taylor TAH. Not Just Fun and Games: Game-Based Learning in Health Professions Education. MEDICAL SCIENCE EDUCATOR 2023; 33:1301-1306. [PMID: 37886278 PMCID: PMC10597927 DOI: 10.1007/s40670-023-01859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 10/28/2023]
Affiliation(s)
- Thomas Thesen
- Geisel School of Medicine, Dartmouth College, Hanover, NH USA
| | - Ingrid Bahner
- Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | | | | | | | - William S. Brooks
- University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL USA
| | - Cassie Chinn
- International Association of Medical Science Educators, Huntington, WV USA
| | - Nehad El-Sawi
- Des Moines University Medicine & Health Sciences, Des Moines, IA USA
| | - Shafik Habal
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA USA
| | - Michele Haight
- Sam Houston State University College of Medicine, Huntsville, TX USA
| | | | - Uzoma Ikonne
- Eastern Virginia Medical School, Norfolk, VA USA
| | - Robert J. McAuley
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI USA
| | | | - Rebecca Rowe
- University of New England College of Osteopathic Medicine, Biddeford, ME USA
| | - Tracey A. H. Taylor
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI USA
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Pelletier J, Romo E, Feinstein B, Smith C, Pellerito G, Croft A. Little Patients, Big Tasks - A Pediatric Emergency Medicine Escape Room. JOURNAL OF EDUCATION & TEACHING IN EMERGENCY MEDICINE 2023; 8:SG1-SG19. [PMID: 37969155 PMCID: PMC10631808 DOI: 10.21980/j89w70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/16/2023] [Indexed: 11/17/2023]
Abstract
Audience The target audience for this small group session is post-graduate year (PGY) 1-4 emergency medicine (EM) residents, pediatric EM (PEM) fellows, and medical students. Introduction Pediatric emergency department visits have been declining since the start of the COVID-19 pandemic, leading to decreased exposure to pediatric emergency care for EM residents and other learners in the ED.1 This is a major problem, given that the Accreditation Council for Graduate Medical Education (ACGME) mandates that a minimum of 20% of patient encounters or five months of training time for EM residents must occur with pediatric patients, with at least 50% of that time spent in the ED setting.2,3 A minimum of 12 months must be spent in the pediatric ED for PEM fellows,2 and an average of 7.1 weeks of medical school are spent in pediatric clerkships.4 This decrease in pediatrics exposure in the post-pandemic environment can be addressed through simulation and gamification. We selected the gamification method of an escape room to create an engaging environment in which learners could interface with key pediatric emergency medicine clinical concepts via group learning. Educational Objectives By the end of this small group exercise, learners will be able to:Demonstrate appropriate dosing of pediatric code and resuscitation medicationsRecognize normal pediatric vital signs by ageDemonstrate appropriate use of formulas to calculate pediatric equipment sizes and insertion depthsRecognize classic pediatric murmursAppropriately diagnose congenital cardiac conditionsRecognize abnormal pediatric electrocardiograms (ECGs)Identify life-threatening pediatric conditionsDemonstrate intraosseous line (IO) insertion on a pediatric modelDemonstrate appropriate use of the Neonatal Resuscitation Protocol (NRP®) algorithms. Educational Methods An escape room - a form of gamification - was utilized to engage the learners in active learning. Gamification is an increasingly popular educational technique being utilized in graduate medical education and refers to the conversion of serious, non-trivial material into a fun activity fashioned like a game in order to enhance engagement in learning.5 This educational method seeks to enhance knowledge, attitudes, and skills via components of games - such as puzzles and prizes - outside of the context of a traditional game.6 Though high-quality research data on the effectiveness of gamification methods in graduate medical education is limited, studies have shown that gamification enhances learning, attitudes, and behaviors.5,7 One randomized, clinical-controlled trial investigating the use of gamification to enhance patient outcomes found that patients of primary care physicians randomized to the gamification group reached blood pressure targets faster than in the control group.8 Escape rooms as a modality for education have been suggested to improve active learning and enhance learner engagement in the learning process.9 In an escape room, learners are "locked" in an artificial environment (whether digitally or in person) and must utilize their group or individual knowledge to solve puzzles and escape from their "entrapment."9,10 Escape rooms utilized as part of EM residency didactic training have demonstrated learner enthusiasm,11,12 desire to repeat the activity again,13 preference for escape rooms over traditional learning methods,14,15 improved confidence in communication and leadership skills,11,15 and improvement scores from pre- to post-testing.16We developed an escape room in which learners were divided into teams and informed that they would need to "escape" from our resident lounge by successfully completing all nine stations. The first team to complete all nine stations would win a prize. Only after the last team completed the ninth station and debriefing was complete could all teams be "freed" from the escape room. Research Methods Learners provided anonymous online survey feedback regarding the quality of the educational content and the efficacy of the delivery method. Results A post-participation survey was disseminated to 55 residents, 32 of whom attended the PEM Escape Room, with a response rate of 9% (3/32 residents). One hundred percent of respondents felt that the activity content was applicable to their needs as an emergency physician. The session was rated as excellent by 33.3% of respondents, and 66.7% of respondents rated the session as above average. A second survey was disseminated seven months after the event to the 24 remaining residents who attended the event, with a response rate of 46% (11/24 residents); eight attendees had graduated at the time of this survey dissemination. Results of the second survey indicated that 100% (24/24 residents) felt that the activity content was applicable to their needs as an emergency physician, 73% (17/24 residents) rated the session as excellent, and 27% (7/24 residents) rated the session as above average. Discussion Though we received limited survey responses (3/32 on the first survey and 11/24 on the second survey), respondents felt that the educational content met their learning needs and was of high quality. We had six faculty members present to facilitate the escape room while there were four groups of residents (eight per group). The ideal faculty to resident ratio would be one faculty member per group with three to six players, based on prior literature showing that teams of more than six players take longer to complete escape room tasks.17,18 We also recognized the importance of sending out the feedback survey link early because we believe the delay in our survey being emailed to the residents contributed to the low response rate (three trainees).One participant provided the following feedback: "I think the 'escape room' struck an excellent balance with regard to trying to address knowledge that was relevant but also obscure or difficult enough that group/collaborative effort was required. I enjoyed the process and low stakes atmosphere." This quote nicely summarizes our take-aways: That the PEM escape room incorporates key tenets of adult learning theory. Also known as andragogy, adult learning theory posits that adult learners are self-directed, have prior life experiences that shape their learning process, learn for practical reasons (ie, choose to learn in order to fulfill the demands of their social role), and are problem-oriented in their learning.19 Though andragogy does not technically apply only to adults (as many children are self-directed learners),20 having an understanding of the practical and experiential nature via which adults approach learning allows the adult educator to appropriately cater educational activities to meet the adult learner's needs.This escape room aligned with the core tenets of adult learning theory in several ways. Specifically, residents were given autonomy of participation in the escape room and thus had to take initiative to promote their own learning.21 Topics featured in the escape room stations were selected based on their clinical challenges and high-yield for board examinations and patient care, making their relevance immediately obvious to learners; this is a key feature of catering to adult learners.22 The escape room provided a comfortable and collegial environment in which residents felt comfortable learning, fostering an ideal setting for mature learners.21 Direct and immediate feedback are key components of adult learning theory, and faculty members were physically present to provide feedback at each escape room station.22 Finally, working in teams required the learners to engage in active learning rather than acting as passive recipients of cognitive information.21 Thus, the PEM escape room serves as an ideal framework to meet the needs of the adult learner. Topics Pediatrics, emergency medicine, pediatric emergency medicine.
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Affiliation(s)
- Jessica Pelletier
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Ernesto Romo
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Bryan Feinstein
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Charles Smith
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Gina Pellerito
- St. Louis Children’s Hospital, One Children’s Place, St. Louis, MO
| | - Alexander Croft
- Washington University, Department of Emergency Medicine, St. Louis, MO
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Karpa K, Ward J, Stegman M, Berg A, Leong SL. IPEx: A gamification tool for learner application of pharmacologic principles of opioid use, misuse, and addiction. Pharmacol Res Perspect 2023; 11:e01141. [PMID: 37759385 PMCID: PMC10533953 DOI: 10.1002/prp2.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Opioids are often prescribed to treat chronic pain ailments, despite lack of evidence for many conditions. Prescriptions frequently become the gateway to opioid misuse and abuse. In response to the opioid crisis, medical school educators in the state of Pennsylvania developed core competencies pertaining to opioids and addiction for which all medical students should demonstrate proficiency before graduation. To enable students to achieve these competencies, we developed a web-based app (IPEx) that delivers a gamified experience for learners in which they are (re)exposed to opioid competencies and practice applying pharmacologic principles in the context of a series of longitudinal patient scenarios. Learning and application are measured by student responses to application questions before and after each of five modules. Prior to launching the IPEx tool broadly, we wished to test the application questions; thus, we invited fourth year medical students to complete a 45 question quiz based on IPEx module content. Students had no specific preparation prior to taking the quiz but had been exposed to all content elsewhere in the curriculum. A total of 45 of 141 medical students (32%) opted to complete the quiz (mean score was 47% ± 13%; range 18%-73%). Cronbach alpha for the instrument was .74. These results suggest that the instrument has internal validity, and medical students have room for growth when it comes to application of opioid related competencies, a situation that the IPEx tool may be uniquely suited to remedy.
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Affiliation(s)
- Kelly Karpa
- Department of Medical EducationEast Tennessee State University Quillen College of MedicineJohnson CityTennesseeUSA
| | - Josie Ward
- East Tennessee State University Quillen College of MedicineJohnson CityTennesseeUSA
| | | | - Arthur Berg
- Department of Public Health SciencesPennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Shou Ling Leong
- Department of Family and Community MedicinePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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Nelson RE, Jackson CD, Yang Y, Ricotta DN. Enriching Resident Engagement During Whiteboard Mini-Talks. J Grad Med Educ 2023; 15:536-540. [PMID: 37781422 PMCID: PMC10539149 DOI: 10.4300/jgme-d-23-00234.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Affiliation(s)
- Ryan E. Nelson
- Corresponding author: Ryan E. Nelson, MD, Beth Israel Deaconess Medical Center, , Twitter @RyanENelsonMD
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Sandoval-Hernández I, Molina-Torres G, León-Morillas F, Ropero-Padilla C, González-Sánchez M, Martínez-Cal J. Analysis of different gamification-based teaching resources for physiotherapy students: a comparative study. BMC MEDICAL EDUCATION 2023; 23:675. [PMID: 37723502 PMCID: PMC10506183 DOI: 10.1186/s12909-023-04576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/08/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND For health professionals, gamification is a new teaching method that has achieved an important role in recent years, with excellent results in learning and knowledge acquisition. Thus, the objective of this study was to analyze the gaming experience through different gamification resources in the classroom with physiotherapy students. METHODS A comparative study on gamification-based teaching resources was carried out during the first semester of the 2021-2022 academic year. A total of 33 physiotherapy students participated in this study. After the theoretical topics were taught, the participants were invited to participate in different gamification resources such as Kahoot!, Physiotherapy Party and Escape Room. The gaming experience with the different gamification resources was measured with the GAMEX scale. RESULTS The Physiotherapy Party showed a higher score in relation to the enjoyment dimension compared to the Kahoot! and Escape Room (p = 0.004). The Escape Room presented higher scores in absorption, creative thinking, activation and dominance compared to Kahoot! and Physiotherapy Party (p < 0.005). CONCLUSIONS Gamification resources promote enjoyment and creativity in the students in the classroom. The use of new teaching methods based on gamification, such as Escape Room as Physiotherapy Party should be considered as first choice in the use of gamification resources due to the benefits they bring to students.
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Affiliation(s)
- Irene Sandoval-Hernández
- Faculty of Health Sciences, Department of Physical Therapy, University of Granada, Melilla, Spain
| | - Guadalupe Molina-Torres
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain
| | - Felipe León-Morillas
- Faculty of Health Sciences, Department of Physiotherapy, University Catholic of Murcia - UCAM, Murcia, Spain
| | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain.
| | - Manuel González-Sánchez
- Faculty of Health Sciences, Department of Physiotherapy, University of Malaga, Almeria, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, 29010, Spain
| | - Jesús Martínez-Cal
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain
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Cascella M, Cascella A, Monaco F, Shariff MN. Envisioning gamification in anesthesia, pain management, and critical care: basic principles, integration of artificial intelligence, and simulation strategies. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2023; 3:33. [PMID: 37697415 PMCID: PMC10494447 DOI: 10.1186/s44158-023-00118-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
Unlike traditional video games developed solely for entertainment purposes, game-based learning employs intentionally crafted approaches that seamlessly merge entertainment and educational content, resulting in captivating and effective learning encounters. These pedagogical methods include serious video games and gamification. Serious games are video games utilized as tools for acquiring crucial (serious) knowledge and skills. On the other hand, gamification requires integrating gaming elements (game mechanics) such as points, leaderboards, missions, levels, rewards, and more, into a context that may not be associated with video gaming activities. They can be dynamically (game dynamics) combined developing various strategic approaches. Operatively, gamification adopts simulation elements and leverages the interactive nature of gaming to teach players specific skills, convey knowledge, or address real-world issues. External incentives stimulate internal motivation. Therefore, these techniques place the learners in the central role, allowing them to actively construct knowledge through firsthand experiences.Anesthesia, pain medicine, and critical care demand a delicate interplay of technical competence and non-technical proficiencies. Gamification techniques can offer advantages to both domains. Game-based modalities provide a dynamic, interactive, and highly effective opportunity to learn, practice, and improve both technical and non-technical skills, enriching the overall proficiency of anesthesia professionals. These properties are crucial in a discipline where personal skills, human factors, and the influence of stressors significantly impact daily work activities. Furthermore, gamification can also be embraced for patient education to enhance comfort and compliance, particularly within pediatric settings (game-based distraction), and in pain medicine through stress management techniques. On these bases, the creation of effective gamification tools for anesthesiologists can present a formidable opportunity for users and developers.This narrative review comprehensively examines the intricate aspects of gamification and its potentially transformative influence on the fields of anesthesiology. It delves into theoretical frameworks, potential advantages in education and training, integration with artificial intelligence systems and immersive techniques, and also addresses the challenges that could arise within these contexts.
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Affiliation(s)
- Marco Cascella
- Department of Anesthesia and Critical Care, Istituto Nazionale Tumori-IRCCS, Fondazione Pascale, Via Mariano Semmola, 53, 80131, Naples, Italy.
| | | | | | - Mohammed Naveed Shariff
- Department of Artificial Intelligence and Data Science, Rajalakshmi Institute of Technology, Chennai, India
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Gorbaty B, Arango S, Buyck D, James RC, Porter ST, Iaizzo P, Perry TE, Seslar S. Virtual Reality-based Methods for Training Novice Electrophysiology Trainees-A Pilot Study. J Innov Card Rhythm Manag 2023; 14:5583-5599. [PMID: 37781721 PMCID: PMC10540881 DOI: 10.19102/icrm.2023.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/25/2023] [Indexed: 10/03/2023] Open
Abstract
Developing an accurate and detailed 3-dimensional (3D) mental model of cardiac anatomy is critical for electrophysiology (EP) trainees. Due to its immersive nature, virtual reality (VR) may provide a better learning environment than traditional teaching methods for assimilating 3D cardiac anatomy. The purpose of this pilot study was to evaluate the technical feasibility of an interactive, remote VR-based method for teaching cardiac anatomy to novice EP trainees. We created a shared, remote VR environment that allows the shared viewing of high-resolution 3D cardiac models. Eighteen trainees accepted for pediatric and adult EP fellowships were recruited. We performed a cohort study comparing the traditional teaching methods with the VR learning environment. Participants completed a demographic questionnaire and a satisfaction survey. The adult EP trainees were given a multiple-choice pre- and post-test exam to assess their anatomical knowledge. Both the adult and pediatric EP trainee cohorts rated the VR experience positively and preferred the VR environment to the more traditional teaching method. All the participants expressed interest in incorporating the VR learning environment into the EP fellowship curriculum. The usability of the system was relatively low, with approximately one-third of participants rating the system as hard to use. The impact of the VR session on exam performance was mixed among the adult cohort. We demonstrated the feasibility of gathering geographically dispersed EP fellows in training with a shared VR-based environment to teach cardiac anatomy. Although we were not able to demonstrate a learning benefit over the traditional lecture format in the adult cohort, the training environment was favorably received by all the participants.
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Affiliation(s)
- Benjamin Gorbaty
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Susana Arango
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, The Visible Heart Laboratories and the Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN, USA
| | - David Buyck
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
- Liberal Arts Technologies and Innovation Services, University of Minnesota, Minneapolis, MN, USA
| | | | - Samantha T Porter
- Liberal Arts Technologies and Innovation Services, University of Minnesota, Minneapolis, MN, USA
| | - Paul Iaizzo
- Department of Surgery, The Visible Heart Laboratories and the Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Tjörvi E Perry
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Stephen Seslar
- Division of Pediatric Cardiology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
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Bonn J, Mulkey D, Goers J. Using Gamification to Engage Clinical Nurses in Quality Improvement. J Nurses Prof Dev 2023; 39:E148-E153. [PMID: 37683219 DOI: 10.1097/nnd.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Engaging clinical nurses in quality improvement is essential to achieve improved patient outcomes. By using gamification, nursing professional development specialists can increase motivation and improve attitudes toward quality improvement. This project was designed to create and implement a virtual escape room to engage clinical nurses in nursing-sensitive quality improvement. Results revealed that gamification was a valuable active learning strategy that allowed participants to be more immersed in the learning experience.
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Donoso F, Peirano D, Longo C, Apalla Z, Lallas A, Jaimes N, Navarrete-Dechent C. Gamified learning in dermatology and dermoscopy education: a paradigm shift. Clin Exp Dermatol 2023; 48:962-967. [PMID: 37155594 DOI: 10.1093/ced/llad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
Teaching methods in medical education have been changing. More recent teaching modalities have gone beyond the traditional delivery of knowledge, promoting learning motivation, and improving teaching and learning outcomes. 'Gamification' and 'serious games' are methodologies that use the principles of games to facilitate learning processes and the acquisition of skills and knowledge, thereby improving attitudes towards learning when compared with traditional teaching methods. As dermatology is a visual field, images are a key component of different teaching strategies. Likewise, dermoscopy, a noninvasive diagnostic technique that allows the visualization of structures within the epidermis and upper dermis, also uses images and pattern recognition strategies. A series of Apps using game-based strategy have been created to teach and facilitate dermoscopy learning; however, studies are required to demonstrate their effectiveness. This review summarizes the current evidence of game-based learning strategies in medical education, including dermatology and dermoscopy.
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Affiliation(s)
| | | | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Aimilios Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Natalia Jaimes
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Amir LR, Leonardy IC, Dewatmoko SN, Yanuar R, Suniarti DF, Idrus E, Sipiyaruk K, Puspitawati R. Serious game as oral histology learning strategy for undergraduate dental students; crossover randomized controlled trial. BMC Oral Health 2023; 23:585. [PMID: 37612722 PMCID: PMC10463426 DOI: 10.1186/s12903-023-03286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/04/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Oral histology is perceived by dental students as a challenging subject and often struggle to recognize the long-term relevance of understanding the cells and tissues at the microscopic level. Serious games have been reported to have a positive effect on student cognitive skills and learning motivation. However, there is still a limited amount of research supporting the effectiveness of serious games as a learning method in dentistry. The present study aimed to evaluate the impact of serious game of HistoRM as a complementary learning strategy for oral histology. METHODS The study design was a crossover randomized controlled trial. A total of 74 first year dental students of Universitas Indonesia participated in the study and divided into 2 groups. Study intervention included HistoRM game for 3 days followed by a combination of HistoRM and script-based handouts for another 4 days. The groups represented different intervention sequences. Evaluation was performed using pre-test, post-test on day 3 and 7 and a questionnaire. RESULTS The data showed significant improvement of student cognitive skills (p < 0.001) and it was influenced by the number of game missions completed. Students who completed the whole 15 missions have a higher day-7 post-tests scores (p = 0.03). Perception of dental students on HistoRM was positive in all domains tested, the learning content, games and learning experience domains. Immediate feedback given after each gameplay helped the students understand the subject matters. CONCLUSION Serious game of HistoRM effectively improved students' understanding of oral histology learning outcome and provided more interesting learning experiences. This innovative learning can be recommended as a complementary learning strategy of oral histology for dental students.
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Affiliation(s)
- Lisa R Amir
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat 10430, Jakarta, Indonesia.
- Dental Education Unit, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
| | - Irene C Leonardy
- Dentistry Study Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Salsabila N Dewatmoko
- Dentistry Study Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Rezon Yanuar
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat 10430, Jakarta, Indonesia
- Department of Pharmacology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari- Tobetsu, Hokkaido, Japan
| | - Dewi F Suniarti
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat 10430, Jakarta, Indonesia
| | - Erik Idrus
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat 10430, Jakarta, Indonesia
| | - Kawin Sipiyaruk
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ria Puspitawati
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat 10430, Jakarta, Indonesia
- Dental Education Unit, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
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Allon S, Baggett A, Hayes B, Glosemeyer K, Cavo J, Pacha R, Zurko J, Patel N, Kraemer R. Association of a Gamified Journal Club on Internal Medicine Residents' Engagement and Critical Appraisal Skills. J Grad Med Educ 2023; 15:475-480. [PMID: 37637345 PMCID: PMC10449352 DOI: 10.4300/jgme-d-22-00812.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/03/2023] [Accepted: 05/03/2023] [Indexed: 08/29/2023] Open
Abstract
Background Prior literature demonstrates internal medicine residents have suboptimal competence in critical appraisal. Journal clubs are a common intervention to address this skill, but engagement and critical appraisal skill improvement are variable. Objective We evaluated journal club engagement and critical appraisal skills after implementation of a gamified format. Methods This was a single-arm study, conducted from July 1, 2020 to June 30, 2021, involving internal medicine residents at 2 US programs. Residents participated in a 12-month gamified journal club that sorted residents into 2 teams. Residents attended an orientation followed by 6 to 10 monthly, hour-long competitions. In each competition, a subset of the resident teams competed to answer a clinical prompt by critically appraising an original article of their choice. A chief medical resident or faculty member moderated each session and chose the winning team, which received a nominal prize of candy. The primary outcome was engagement, measured by a 7-question survey developed de novo by the authors with Likert scale responses at baseline and 12 months. The secondary outcome was critical appraisal skills assessed by the Berlin Questionnaire. Results Sixty-one of 72 eligible residents (84.7%) completed both engagement surveys. Residents reported statistically significant improvements in most dimensions of engagement, including a higher likelihood of reading articles before sessions (posttest minus pretest score -1.08; 95% CI -1.34 to -0.82; P<.001) and valuing time spent (posttest minus pretest score -0.33; 95% CI -0.55 to -0.11; P=.004). Critical appraisal skills marginally improved at 12 months (posttest minus pretest score -0.84; 95% CI -1.54 to -0.14; P=.02). Conclusions Our study demonstrates a gamified journal club was associated with improvements in engagement and minimal change in critical appraisal skills.
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Affiliation(s)
- Steven Allon
- Steven Allon, MD, is Assistant Professor of Medicine, Vanderbilt University Medical Center
| | - Alan Baggett
- Alan Baggett, MD, is Associate Professor of Medicine, University of Alabama at Birmingham-Huntsville
| | - Benjamin Hayes
- Benjamin Hayes, MD, is Assistant Professor of Medicine, Northside Hospital Gwinnett
| | - Katherine Glosemeyer
- Katherine Glosemeyer, MD, is Assistant Professor of Medicine, University of Alabama at Birmingham-Huntsville
| | - Jose Cavo
- Jose Cavo, MD, is Assistant Professor of Medicine, University of Alabama at Birmingham-Huntsville
| | - Rami Pacha
- Rami Pacha, DO, is Assistant Professor of Medicine, Northside Hospital Gwinnett
| | - Joanna Zurko
- Joanna Zurko, MD, is Assistant Professor of Medicine, University of Wisconsin
| | - Nidhip Patel
- Nidhip Patel, DO, is Associate Professor of Medicine, Northside Hospital Gwinnett; and
| | - Ryan Kraemer
- Ryan Kraemer, MD, is Associate Professor of Medicine, University of Alabama at Birmingham
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